Phenotyping and Genotyping Evaluation of E. coli Produces Carbapenemase Isolated from Cancer Patients in Al-Basrah, Iraq

One of the most important nosocomial organisms that cause urinary tract infections (UTIs) in cancer patients is Escherichia coli. A significant cause of concern in managing UTIs is the development of carbapenem-resistant bacteria. Escherichia coli with carbapenem resistance has become a more serious problem, particularly in Iraq. In this regard, the present study aimed to estimate the prevalence of carbapenem-resistant E. coli in Al-Basrah, Iraq. Conventional tests and the Vitek®2 system were used to identify the isolates and determine the susceptibility of E.coli isolates to antimicrobials. In addition, E.coli isolates were tested by mCIM and eCIM methods. Moreover, the major carbapenemase genes, including blaSPM, blaIMP, blaVIM, and blaKPC were detected by polymerase chain reaction. In total, 120 urine samples were collected from cancer patients who were suspected of having urinary tract infections at Basrah Center of Oncology Al-Sader Teaching Hospital, Basrah, Iraq. Identification of bacterial growth by using biochemical tests revealed different bacterial species. The most frequent bacteria were E. coli (n=22, 53.65%) isolates. The results showed that 13 (59.09%) and 11 (50%) out of 22 E. coli isolates were positive for the production of carbapenemase, based on the eCIM and sCIM, respectively. The majority of E.coli in this study possessed the blaVIM gene (n=13, 59.1%), followed by the blaKPC gene (n=5, 22.73%), blaIMP gene (n=5, 22.73%), and blaSPM gene (n=4, 18.18%). There is a spread of more than one type of carbapenemase among the E. coli isolates collected from UTI cancer patients in Basrah Hospital. The E. coli identified in the current study had a strong capacity to produce carbapenemase enzymes against the four generations of antibiotics, including imipenem and meropenem antibiotics.